This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Long term survivors of treated childhood malignancies experience an increased incidence of cardiovascular events including acute coronary and cerebro-vascular syndromes, and congestive heart failure (CHF). These untoward, long-term complications of cancer treatment (chemotherapy and radiation therapy) adversely impact the functional capacity, morbidity, and mortality of otherwise relatively healthy 20 to 40 year-old individuals. At present, markers to identify asymptomatic cancer survivors at increased risk of developing cardiovascular events do not exist. Moreover, understanding of the mechanisms by which cancer treatment could influence the occurrence of cardiovascular events is unavailable. MRI markers are precise in older adults, and forecast cardiovascular events independent of the presence of clinical conditions, such as hypertension, diabetes, and hypercholesterolemia that are also known to be associated with adverse outcomes. We therefore propose to apply cardiac MRI in an institutional pilot study of cardiovascular health in childhood cancer survivors. Our overarching goal is to evaluate the utility of cMRI in delineating predictors of adverse cardiovascular outcomes in childhood cancer survivors at risk. To accomplish these submissions, we need to determine the feasibility of acquiring prognostic MRI information in survivors of childhood cancer, and define the variance of these MRI measures in a young adult population for determining sample sizes in future studies.